May 4, 2019Heart
Ischaemic and bleeding risk assessment after myocardial infarction: combination is the key
Population
Patients admitted for acute myocardial infarction
Design
Editorial
Authors
Discussion
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Member takes
Implication
Highlights the importance of concomitantly evaluating ischemic and bleeding risks to select patients who will benefit from potent antithrombotic strategies after myocardial infarction.
Key Points
- Evaluate the clinical utility of concomitantly assessing recurrent ischaemic and bleeding risks using key clinical risk factors to guide antithrombotic therapy after acute myocardial infarction.
- Analyzed data from the nationwide SWEDEHEART registry comprising more than 100,000 patients admitted with acute myocardial infarction.
- Assessed models combining established clinical risk factors associated with adverse cardiovascular outcomes to predict both ischaemic and major bleeding events.
- Potent antithrombotic regimens reduce recurrent ischaemia but systematically increase serious bleeding complications across post-infarction cohorts.
- Concomitant evaluation of shared baseline risk factors enables clinicians to identify subsets of patients who achieve net clinical benefit from intensified secondary prevention.
Structured PICO
P
Population
Patients admitted for acute myocardial infarction (MI) (referencing the SWEDEHEART registry with >100,000 patients)
I
Intervention
Combination of key clinical risk factors for risk assessment
O
Outcome
Recurrent ischaemic and bleeding risks
Highlights the importance of concomitantly evaluating ischemic and bleeding risks to select patients who will benefit from potent antithrombotic strategies after myocardial infarction.
Cite This Study
Darmon et al. (2019) studied this question.